摘要目的 探索1型糖尿病(T1DM)患者外周血浆细胞样树突状细胞(plasmacytoid dendritic cells,pDCs)与其他免疫细胞和临床指标的相关性,初步探讨pDCs在T1DM发病中的作用.方法 选取2015年12月至2017年6月在南京医科大学第一附属医院内分泌科就诊的62例T1DM患者为研究对象,同时招募74名年龄、性别相匹配的志愿者作为健康对照组.记录受试者年龄、性别、病程和糖化血红蛋白(HbA1c)水平.采用流式细胞术检测T1DM患者外周血pDCs和其他各淋巴细胞亚群[CD3+、CD4+、CD8+、CD4+干扰素(IFN)-γ+、CD4+肿瘤坏死因子(TNF)-α+、CD4+白细胞介素(IL)-4+、CD4+IL-17+和CD4+CD25+叉头框蛋白3(Foxp3)+T细胞及CD19+和CD19+CD24hiCD38hiB细胞]的比例.计算Pearson相关系数进行相关性分析.结果 T1DM组和健康对照组外周血pDCs比例差异具有统计学意义[(0.21±0.13)%比(0.28±0.14)%,t=-0.28,P=0.006].Pearson相关分析提示T1DM患者外周血pDCs数量与分泌IFN-γ及TNF-α的CD4+T细胞数量呈负相关(r=-0.260、-0.473,均P<0.05),与CD4+CD25+Foxp3+T细胞及CD19+CD24hiCD38hiB细胞数量呈正相关(r=0.417、0.523,均P<0.05),与HbA1c水平呈负相关(r=-0.316,P<0.05).结论 T1DM患者外周血pDCs存在数量水平的缺陷,可能与T1DM免疫失衡有关,参与了T1DM的发病.

abstractsObjective To explore the correlations between circulating plasmacytoid dendritic cells (pDCs)and other immune cells,clinical parameters in patients with type 1 diabetes mellitus(T1DM),and to investigate the role of pDCs in the pathogenesis of T1DM.Methods A total of 62 patients with T1DM who visited endocrinology at the First Affiliated Hospital of Nanjing Medical University from December 2015 to June 2017 were recruited as study group.A total of 74 age and gender matched healthy volunteers were as the control group.Clinical parameters of all subjects including age,sex,duration of diabetes and HbA1cwere recorded.The proportions of circulating pDCs and other immune cells[CD3+,CD4+,CD8+,CD4+interferonγ+(IFN-γ+), CD4+tumor necrosis factor α+(TNF-α+), CD4+interleukin 4+(IL-4+), CD4+IL-17+/CD4+CD25+Foxp3+T cells/CD19+/CD19+CD24hiCD38hiB cells] were detected by flow cytometry. Pearson correlation analysis was performed to explore the correlation. Results The differences in the proportions of pDCs between T1DM patients and healthy controls were statistically significant[(0.21±0.13)% vs(0.28±0.14)%, P=0.006]. Pearson correlation analysis showed that the frequency of circulating pDCs were negatively correlated with the frequency of CD4+IFN-γ+and CD4+TNF-α+T cells(r=-0.260,0.473,respectively,both P<0.05), and positively correlated with the frequency of CD4+CD25+Foxp3+Tcells and CD19+ CD24hi CD38 hiB cells(r=0.417,0.523,respectively,both P<0.05).There was also a negatively correlation between the frequency of circulating pDCs and HbA1c(r=-0.316, P<0.05). Conclusion There is a deficiency of circulating pDCs in peripheral blood of patients with T1DM, which might be correlated with immune imbalance of T1DM,and be involved in the pathogenesis of T1DM.